Electroconvulsive Therapy

(Therapy, Electroconvulsive; ECT)

Definition

Electroconvulsive therapy (ECT) sends an electronic current through the brain. This current causes brief seizure activity. This causes changes in brain chemistry. ECT can reduce symptoms associated several mental health conditions.

Pregnancy—this form of therapy may increase the risk of complications in the fetus

Not responding well to medication

Increased age

What to Expect

Prior to Procedure

Prior to the procedure, your doctor will:

Do a physical exam

Do a complete medical and psychological history

Ask you about any medications you are taking, including prescription and over-the-counter medications

Have tests done, which may include blood tests, an
electrocardiogram (EKG)
, and imaging of the brain

Have you meet with an anesthesiologist

Give you instructions about not eating or drinking before the procedure

You may feel confused after ECT. Arrange for someone to drive you home from the hospital. Also, arrange for someone to help you at home.

Anesthesia

General anesthesia
will be used. You will be asleep during the treatment and will not feel any pain.

Description of Procedure

You will be connected to a machine that will monitor your vital signs and brain activity. Next, you will receive general anesthesia and a medication to keep your muscles relaxed during the procedure.

After you are asleep, you will receive oxygen through a mask on your face. A mouth guard may also be placed to protect your tongue and teeth from injury. Next, electrodes will be positioned on your head. These electrodes will be connected to a machine that will deliver an electric current to your brain. This will cause seizure activity. After the shock is given, the muscles that have not been affected by the medication will contract for a few seconds. Next, your body will twitch, which can last up to a minute.

Immediately After Procedure

You will be taken to a recovery room where your vital signs will be monitored. You will wake up in 10-15 minutes. You may feel confused. This confusion can last minutes, hours, or sometimes longer.

How Long Will It Take?

About 30 minutes, including time to recover after the procedure

How Much Will It Hurt?

You will not feel any pain during the procedure. After ECT, you may have a headache and muscle aches or soreness.

Post-procedure Care

At the Care Center

When you are fully awake, you will be given something to eat and drink. In most cases, you will be able to go home the day of the procedure.

At Home

You should arrange for help at home in case thinking and memory problems persist.

You will need to schedule an appointment for another ECT treatment. In most cases, you will need to have 2-3 treatments per week, for many weeks. You will need to take medication, such as antidepressants, and continue with therapy to prevent a relapse.

You may also need maintenance ECT to further prevent a relapse. Your doctor will help determine the right plan for you. This will depend on how you are progressing.

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

Worsening of symptoms, including feelings of hopelessness or helplessness and thoughts of suicide—If you have thoughts of suicide, call your doctor or therapist right away.

CANADIAN RESOURCES

References

Depression: How electroconvulsive therapy works. American Academy of Family Physicians Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/depression/treatment/how-electroconvulsive-therapy-works.html. Updated September 2012. Accessed May 6, 2016.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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